Effectiveness of Tobacco Cessation Intervention in Tobacco Cessation Clinics, India: A Systematic Review

Introduction: Tobacco use presents a formidable public health challenge globally, and India is no exception, bearing a significant proportion of the worldwide disease burden attributable to tobacco consumption. Recognising this critical health crisis, Tobacco Cessation Clinics (TCC) have been established across India to provide specialised support for individuals aiming to quit. Aim: The present systematic review was aimed to explore the effectiveness of tobacco cessation intervention in TCCs in India. Materials and Methods: A search for relevant studies was conducted using the keywords ‘tobacco cessation India,’ ‘smoking cessation clinics India,’ ‘tobacco use cessation intervention India,’ and ‘pharmacotherapy smoking cessation India’. The search yielded 330 studies in PubMed, Google Scholar, Embase, and SCOPUS between 2004 and 2024. After duplicates were removed 52 full-text articles were retrieved and assessed for eligibility. Eligibility criteria included Randomised Controlled Trials (RCT) or quasi-experimental studies or cohort studies of any smoking cessation intervention with no age or gender limitation. The risk of bias was assessed using similar criteria for RCT and non-randomised studies guided by the Cochrane Handbook for Systematic Reviews. Results: A total of 10 studies (1613 Indian tobacco users) with mean age of the participants ranged from 34 years to 50 years were included. The current systematic review identified different cessation methods, with some employing both behavioural change and pharmacological methods, and some utilising only one method. The most commonly used interventions were cognitive behaviour education (n=23), motivational interviewing (n=19), and pharmacotherapy (n=3). Among them, counselling and behavioural support can improve smoking cessation rates along with pharmacotherapy, but the effect varies depending on the characteristics of the support provided. Conclusion: There were numerous tobacco cessation interventions for tobacco users in India, but the most effective intervention to change tobacco consumption behaviour is the combination of pharmacological and behavioural interventions. However, longer follow-up periods indicated reduced effectiveness.